Turf Toe

You may be wondering what is turf toe, and do you have it? Turf toe is an injury of the soft tissue  structure in the plantar complex of your foot; or better explained in simplest terms as a sprain and pain in your big toe due to hyper-extension such as pushing off into a sprint.

Turf Toe Symptoms, Missouri Orthopedic Care Saint Louis, Orthopedic Doctor in Missouri

Most often, this is found in athletes who are pushing off their toes causing your big tor to hyper-extend.  Similar to other injuries that can occur to the body, there is a range of severity when it comes to turf toe and how it can effect you and the sports you play. These mild to severe injuries include:

Level 1 – This is the mildest pain you may feel with surf toe. You may experience tenderness and slight swelling.

Level 2 – This level is selected when there is a partial tear present causing more tenderness than level 1, and more swelling and may include bruising. Moving your toe(s) can be very limited and painful.

Level 3 – A complete tear has occurred leaving you with severe tenderness, swelling and bruising. It is almost too difficult to even more your big toe(s).

If you believe you are experiencing turf toe, seek medical advice and treatment from Dr. Irvine who specializes in foot and ankle injuries. You can call 314-567-5850 to schedule your appointment.

Take Concussions Seriously

Signs of concussion

Before hitting the football, baseball and soccer fields for practice in your upcoming fall season, make sure you are informed & educated on concussions.

What is a concussion? Long term damage to the brain due to an injury.

Concussions can happen to anyone who plays any sport, including sports such as basketball, wrestling, tennis & gymnastics. If you suspect someone has a concussion, the most important thing you can do is to remove them from the field of play and have them seek medical help. Hopefully your coach went though a training course on how to recognize when one of their player may be experiencing symptoms of a concussion.  Some concussion signs to look for include:

  • Confusion
  • Appearing dazed
  • Acting clumsy or moving rather slow
  • Memory loss. For example: the score of the game, or where they are
  • Unconsciousness

If you are a parent reading this article, we caution you against debating the authority the coach may make to remove your child from the game upon suspecting they are experiencing a concussion.  It is better to be safe, than sorry. And, returning to a game while experiencing a concussion can really cause some further brain trauma.

Just remember, that after seeking medical help for a concussion, it is important to continue to build your way back to recover and take things slow. And, that includes the doctors specific orders they may give about returning to the sport & playing field.

Upon receiving approval from a doctor to regain their physical activity, and they have been cleared to begin working out again, we suggest taking exercise slow. Concussions are a serious issue and it is important athletes take the time they need to recover from any head injury before returning to play.

For any questions regarding concussion or the safety of your health while playing on the field, give Dr. Irvine a call today.

Workout revovery like a professional athlete

Recover from your workout like a professional athlete


You might not have the money dedicated to training like a professional athlete, but that doesn’t mean you shouldn’t be able to train like one. Professional athletes and their trainers know that the secret to successful training is recovery.

We cannot stress enough how important recovery is in avoiding injuries. At Missouri Orthopedics, we know that most of you do not have the option to hire massage therapists to be at your disposable. That being said, below are some techniques you can perform yourself without having to shell out big bucks.

1. Contrast Showers

A contrast shower, alternating between hot and cold water, may be better to relieve muscle soreness than a full hot shower. Temperature extremes dilate and constrict your blood vessels, moving metabolic waste products away from your muscles and bringing oxygen and nutrients back to them.
Here’s how to do it: Start with five to 10 minutes of warm water. Then repeat trading off between one minute of cold water followed by one minute of warm water four to five times.

2. Drink Your Protein

30 minutes after exercise is the perfect time for a protein shake. It may help to repair damaged muscles and aid in recovery. Whey shakes are what we highly recommend going with. Whey is a protein found in milk which contains the amino acid leucine. It has been shown to jump-start muscle protein synthesis. For better results, blend in a nutrient-dense green-powder supplement or other antioxidant-rich ingredients, such as dark, leafy greens or berries. Antioxidants neutralize free radicals, a byproduct of hard training that can damage your cells.

3. Myofascial Release

Dedicate at least 10 minutes a day to self-myofascial release (SMR). This process works out muscle knots and relieves tension in the fascia (the tissue covering our muscles). While SMR can be done after workouts, it can also be done before a workout to get your body tissue primed to be lengthened through mobility work. If you use a foam roller prior to exercise, spend another 10 minutes doing mobility exercises. This pre-workout routine promotes more efficient movement during exercise and less wear and tear on your joints.

4. Ice Baths

Ice baths have been shown to reduce muscle soreness. It’s an extreme technique and it takes a little getting used to, but when you experience how fresh your muscles feel afterward, you’ll be hooked just like many NBA players are during halftime. All you need is a tub, a couple of bags of ice and the courage to soak for five to 10 minutes.

5. Sleep

The final and most important piece of recovery is sleep. Your body continues to repair itself during sleep. Lack of sleep interferes with the protein synthesis that helps your muscles grow. Make an effort to go to bed earlier so you can get the recommended seven to nine hours of shut-eye a night. Give yourself time to wind down before you go to sleep and avoid using a laptop or phone too close to bedtime. Stick to a routine so that you are sure to get a good night’s rest.

Original: http://www.livestrong.com/blog/5-tools-help-recover-like-professional-athlete#ixzz3872V7DnY

Youth Sports: Avoid Overuse & Prevent Osteoarthritis


Dive head first into the right of passage of 2014 youth sports!


Playing a sport is a a right of passage when you are a child, but today, youth sports are starting younger and getting more competitive than ever before. It is estimated that 30 million children and adolescents participate in sports each year and 70% of children between the ages of 5 and 17 will play at least one team sport. The peak ages of sports participation is between 13 and 14 years old. There are many health and social benefits to sports, but there are also problems, including sport-related injury which can have a long-lasting impact. In fact, 3 ½ million children and teens will visit the emergency room with a sports-related injury annually.

But aren’t sports supposed to be healthy? Yes, but they should be approached with caution and it should be kept in mind that sports are supposed to be fun. Along with an increase in youth sport participation there also appears to be an increase in pressure to be highly competitive. As a result, kids are playing one or more sports year round, ignoring pain, and minimizing injuries to “get back in the game.” This makes them more vulnerable to both overuse and impact injuries.

What does all of this overuse and injury mean to young, developing bodies? Injury during youth sports can increase the risk of knee, hip and ankle Osteoarthritis in adulthood. In fact, the risk of developing Osteoarthritis of the knee following an ACL injury is 50%.

Osteoarthritis (OA) is a painful disease that effects more than 27 million Americans. It is the leading cause of disability in the US and the most common type of arthritis. By age 40, 90% of all people will have some level of OA in their weight bearing joints. OA occurs when the cartilage that acts as a cushion around the joint becomes thinner and rougher causing the bones to eventually rub against each other.

Being overweight, age, family history, being female, and damage to tissues secondary to sports or other injury are all factors that contribute to the development to OA. Though there are several risk factors that contribute to OA, managing the intensity of participation in sports and preventing sports injuries as much parents can, goes a long way.

It is the responsibility of parents and guardians to keep the young athletes grounded and remember that sports are a healthy form of exercise and a great way to learn about teamwork. Having fun and staying fit is where it should begin and end. There are certainly many talented youths who can go far in their sport and have many doors open because of it, but not at the risk of their health and well being.

• Exercise is certainly a preventative factor in OA. It is the sports injury that increases risk. Keep in mind that soccer, football, weight lifting, and rugby carry the highest risk for knee injury particularly among female athletes.
• Exercise regularly but avoid REPETITIVE stress on the joints. Alternate between a few different sports if you’re going to play all year long. Focus on proper technique in sports and cross-training.
• Collectively take 10 weeks off of all sports each year.
• Listen to your pain and take time to recover from injury or strain. Pain is your body’s signal that you are overdoing it. Previous joint injury is a common cause of OA because the improper alignment that results from injury wears away at the cartilage once sports resume. Make sure you seek proper treatment and allow for a full recovery before returning to the sport.
• Realzie how important health & nutrition are. Being even 10 pounds overweight increases force on the knee by 30 to 40 pounds with each step taken increasing the risk of injury.

Staying active in sports is a great thing for our children and exercise prevents many health problems. Yet we need to be aware that some sports carry a greater risk of injury to joints than others. Knee injury prevention and proper medical management post-injury may go a long way in preventing the pain and debilitation of OA in the future.

Original: http://www.wholesomeone.com/article/preventing-youth-sports-injuries-may-prevent-future-osteoarthritis

The Concussion Discussion

The Concussion Discussion

When is it OK to return to play?

St. Louis OrthopedicsWith a snap a 320-pound Charger kicks up his front limbs and hurls forward with mighty determination only to lose the battle to an oncoming jumbo jet that jarred his head at over 80 G’s.

No this is not a horse race or a flight simulation, but rather an NFL football game in which San Diego Charger’s linebacker Kris Dielman received a concussion on Oct. 23rd, which sent him in to a seizure on the airplane hours after the game. This was after his team deemed him fit enough to remain in the game even though he wobbled and appeared disorientated and cleared him for the flight home.

So what constitutes a concussion and how hard is too hard when getting “your bell rung” in contact sports such as football?

Benching the Brain
A concussion is typically caused by a severe head trauma during which the brain moves violently within the skull. The brain cells all fire at once, much like a seizure. Some studies show that patients who suffer a concussion appear to have the brain activity of people in a coma. Some blows produce unconsciousness and others may not depending on the person and the type of blow sustained.

HITS System hits back
Some concussion’s can be compared to suffering an impact at speeds similar to a serious car wreck and the same technology that deploys airbags and saves lives on the street is now being used to save lives on the field.

Riddell, which is the official helmet worn by NFL players, created a Head Impact Telemetry (HITS) System to a test and diagnose concussions through helmet impact by measuring the location, magnitude, duration and direction of head impacts and impact accumulations. This data is transmitted wirelessly to the sideline to provide coaches and medical staff with valuable information – in real-time if they choose – that can be used to identify potentially dangerous head impacts.

The resulting reaction force is expressed in g-force (with one g being equal to the force of gravity). The NFL began using this technology during the 2011 season and research conducted by them has determined that 98 G’s is the threshold for concussions.
Apart from the data, concussion symptoms may include: Confusion, disorientation, memory loss, unconsciousness, unequal size pupils, headache, dizziness, tinnitus, nausea, vomiting or vision changes. In any case, which these symptoms are evident the brain must be put through a battery of tests and before continuing with play.

St. Louis OrthopedicsDiagnosis of ImPACT
The ImPACT (Immediate Post-Concussion Assessment and Cognitive Testing) program is currently used at many high schools and colleges, as well as the National Football League and National Hockey League. It is a 20-minute test that measures attention span, working memory, sustained & selective attention time, response variability, non-verbal problem solving and reaction time.

ImPACT has also designed a new app you can download. This free application consists of educational material regarding the prevention of concussion and mild traumatic brain injury, and a brief quiz designed to teach athletes, parents and others about the injury and to correct some of the misconceptions about the injury.

Taking on Technology
To date, the HITS system has gathered data on over 1.5 million head impacts giving them the knowledge to create more effective equipment. Thus, in January 2011, Riddell debuted their new Riddell 360 helmet in the National College Championship. The new helmet was redesigned to address key aspects of the helmet including the upper front of the helmet and facemask to better protect its front section. “The helmet reduces the force of impact to the front of a player’s head, where 70 percent of hits occur,” said Thad Ide, Riddell’s senior vice president of research and development.

Faceguards, which are usually made of carbon steel and attached the upper front of the helmet, now has a carbon steel hybrid, which is attached to the side of the helmet with hinge clips, allowing the faceguard to flex on impact, absorbing more of the energy before returning to its original shape. There is also a continuous padding arrangement on the inside of the helmet with a hexagonal design that forms to the player’s head via an inflatable liner in the side and back for a custom fit. This will prevent a player’s head from moving around inside the helmet, and keeps the helmet from popping off.

The Game Changer
Now football is just one sport this article focuses on, but concussions can occur in just about any sport or even a simple slip and fall accident and if not treated properly the brain can endure serious long-term effects, such as memory disturbances, poor concentration, irritability, sleep disturbances, personality changes, depression or fatigue. And when 10% of high school athletes sustain a concussion each season the chance of having a serious brain injury is a higher possibility, which may not just change the game, but also their lives.